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CaHuman trials

Cagrilintide

A once-weekly long-acting amylin analogue. Studied alone and with semaglutide as CagriSema. Not approved anywhere yet.

Investigational · not approvedPhase 3 done as CagriSema
OverviewDosingMixingResearchCommunitySafetyFAQSources

Cagrilintide quick reference

TypeLong-acting amylin analogue
Studied forWeight loss, alone and with semaglutide
EvidencePhase 2 alone; phase 3 as CagriSema
RouteWeekly subcutaneous injection
Half-lifeAbout 7 days

What is Cagrilintide?

Once-weekly copy of amylin, a fullness hormone released with insulin.

People add it to a GLP-1 drug for extra appetite control.

Not approved. Best data are for CagriSema, the semaglutide combination.

How Cagrilintide works

Amylin receptor

Boosts fullness signals in the brain after meals.

Slower stomach emptying

Food leaves the stomach more slowly.

Separate from GLP-1

Works through a different pathway, so effects can add up.

Long-acting

Built to last about a week, unlike natural amylin.

What Cagrilintide is studied for

PeopleWeight loss alone

4.5 mg lost 10.8% in 26 weeks vs 9.0% on liraglutide.

PeopleWeight loss with semaglutide

CagriSema lost 20.4% at 68 weeks vs 3.0% on placebo.

PeopleType 2 diabetes

CagriSema lost 13.7% in people with diabetes (REDEFINE 2).

PeopleBlood pressure

CagriSema cut systolic pressure 10.9 mmHg vs 2.8 on placebo.

PeopleBody composition

CagriSema cut fat mass 35.7% and lean soft tissue 14.4%.

PeopleVersus tirzepatide

CagriSema missed non-inferiority to tirzepatide 15 mg (REDEFINE 4).

Cagrilintide dosing protocol

WeeksWeekly cagrilintide amount in REDEFINE 1
1–40.25 mg
5–80.5 mg
9–121 mg
13–161.7 mg
17+2.4 mg

Combining cagrilintide with tirzepatide or retatrutide has not been studied in a controlled trial.

TRIAL START (CAGRISEMA)0.25 mg weeklyTrial
TRIAL STEPS0.5, 1, then 1.7 mg, 4 weeks eachTrial
TRIAL TARGET2.4 mg weeklyTrial
PHASE 2 RANGE0.3–4.5 mg weekly for 26 weeksTrial
COMMUNITY STEPSSame 4-week steps as the trialsCommunity
COMMUNITY PAIRINGBeside tirzepatide or retatrutide (unstudied)Community

Label and trial amounts come from the sources below. Community amounts are what people report; they have not been tested.

Mixing

Vial10 mg
+
BAC water2 mL
=
Strength5 mg per mL

No tested mixing recipe exists. Community practice only; store at 2–8 °C.

Open the peptide calculator

What the research found

REDEFINE 1 (3,417 adults with obesity or overweight, no diabetes, 68 weeks). Average body-weight change if everyone stayed on treatment:

−22.7%CagriSema 2.4 / 2.4 mg
about −16%Semaglutide 2.4 mg alone
about −12%Cagrilintide 2.4 mg alone
−2.3%Placebo

Garvey WT et al., N Engl J Med 2025. Regardless of adherence the NEJM headline was −20.4% vs −3.0% placebo. Single-drug figures (16.1%, 11.8%) are the same adherent-only analysis, as cited in Verma et al., Hypertension 2026.

Cagrilintide community experience

What users report. Not tested in trials.

Positive reports

  • Physical fullness Users feel it in the body, not only as fewer cravings.
  • Harder to overeat Big meals feel uncomfortable because food sits longer.
  • Plateau breaker Some say adding it restarted stalled weight loss.

Negative & mixed

  • Fatigue Tiredness shows early or after step-ups; many say it fades.
  • Too full Nausea, bloating and constipation make protein goals hard.
  • Unpleasant satiety Some dislike the heavy fullness more than GLP-1 appetite loss.

Cagrilintide stacking

Cagrilintide + semaglutide

Tested as CagriSema in phase 3: 20.4% loss at 68 weeks.

Cagrilintide + tirzepatide

Not studied together; stomach side effects may stack.

Cagrilintide + retatrutide

Not studied together; stomach side effects may stack.

Cagrilintide side effects & safety

Common

  • Nausea: 20–47% on cagrilintide alone vs 18% on placebo (phase 2).
  • Any stomach side effect: 41–63% vs 32% (phase 2).
  • Injection-site reactions were also common (phase 2).
  • With semaglutide: nausea 55%, constipation 31%, vomiting 26%.
  • Worse during step-ups.

Less common

  • Stopped for side effects: 6% on CagriSema vs 3.7% on placebo.
  • Rarer risks are unclear; trials ran only 26 to 84 weeks.
  • No safety data for pairing with tirzepatide or retatrutide.

Precautions

  • Investigational: no approved label or dosing.
  • Stomach effects stack with other appetite-lowering drugs.
  • Pairing with tirzepatide or retatrutide has no safety data.
  • Not studied in pregnancy or breastfeeding.

Our verdict on Cagrilintide

Real weight loss alone and with semaglutide, through a separate fullness pathway. Still unapproved; other pairings are untested.

Cagrilintide FAQ

Is cagrilintide approved?

No. It is studied alone and as CagriSema with semaglutide.

How much weight loss does it cause alone?

About 11.8% at 2.4 mg over 68 weeks if adherent (REDEFINE 1).

Is CagriSema better than tirzepatide?

REDEFINE 4: 20.2% vs 23.6% at 84 weeks; non-inferiority missed.

Can I add it to tirzepatide?

No trial has tested it. Stomach side effects may add up.

Sources

  • Garvey WT et al. N Engl J Med 2025 (REDEFINE 1)
  • Novo Nordisk REDEFINE 1 releases, 2025
  • Lau DCW et al. Lancet 2021;398:2160 (phase 2, cagrilintide alone, NCT03856047)
  • Enebo LB et al. Lancet 2021;397:1736 (phase 1b with semaglutide, half-life)
  • Novo Nordisk release, June 22, 2025 (REDEFINE 1 and 2, body composition)
  • Verma S et al. Hypertension 2026;83:e26055 (REDEFINE 1 blood pressure)
  • Novo Nordisk announcement, Feb 23, 2026 (REDEFINE 4 vs tirzepatide)
  • ClinicalTrials.gov NCT07220642 (cagrilintide alone, phase 3)